Background: Fracture of the penis is a urological emergency which occurs as a result of abrupt trauma to an erect penis. Immediate surgical repair is the standard of care and is superior to non- operative management due to excellent long term outcomes. Objective: The aim of this study was to investigate surgical and functional outcomes in patients who underwent penile fracture repair. Methods: A cross sectional descriptive study was conducted during the period of July 2017-June 2018 to find out the pattern of surgical management of fracture penis among the patients admitted in the urology department of Dhaka Medical College Hospital. A total 50 patients of fracture patients were selected purposively. Outcome of surgical management was investigated by using semi structured and International Index of erectile function questionnaire. Results: The study reveals that the mean age of the patients were 34.26±9.96 (range: 18–65), predominantly married (70%). The mean follow-up period was 12 weeks. Patients ‘history and clinical examination were highly sensitive and accurate in predicting a tunical tear. 15 patients (30%) received surgical treatment within six hours from the hospital admission, while 31 patients and 4 others seek surgical intervention within 6-24 hours and more than 24 hours respectively. It was revealed that the presenting symptoms were pain (72%), penile swelling (100%), eggplant deformity (100%), and hematuria (22%) with associated urethral injury in 22% of patients. Post- operative complications found were infection (14%), penile nodule (26%), chordee (14%), painful erection (16%) and erectile dysfunction (34%). There is a significant relationship between having painful erection and erectile function of the patients at the time of interview [X²=23.44, df=4, p=0.000], The relationship between the time elapsed from hospital admission to surgery and erectile function at the time of interview was not significant [X²=10.39, df=8, p=0.239]. The relationship ..
Background: Prostate cancer is common in urological practice. Diagnosis of prostate cancer depends on biopsy of the prostate. For the last two decade TRUS guided 6 core (sextant) biopsy is being considered as standard for prostate biopsy. Various studies in different countries showed the drawback of sextant biopsy. The debate remains alive on number of biopsy core which is appropriate for obtaining representative tissue. Moreover, more number of needle biopsy may be associated with more complication. Methods: In this hospital based Quasi experimental study, a total of 50 patients were allocated into two groups by purposive sampling technique where 6 core prostate biopsy in one group and 12 core biopsy in another group. Baseline demographic and clinical data were recorded. Post procedural morbidity & histopathological findings were recorded. All the collected data were compiled. Further Statistical analyses of the results were obtained by using Microsoft Xcel, 2010 and web based computer software - Graph Pad Software, 2017. A probability value (p) of less than 0.05 was considered to indicate statistical significance. Results: The baseline characteristics like age, S.PSA, prostate volume & DRE findings were similar in two groups. Cancer detection rate was not significantly different between the 6 core biopsy group and 12 core biopsy group (48% Vs 60%, p=0.395). Dysuria with difficulty in micturition and hematuria after biopsy significantly more in 12 core biopsy group (24% Vs 44% and 32% Vs 60% respectively). Other post procedural complications like fever, perrectal bleeding was found statistically not significant between two groups Conclusion: Trans rectal ultrasound guided 6 core biopsy is equally effective as Trans rectal ultrasound guided 12 core biopsy for detection of prostate cancer.
Background: Stricture urethra is a frequent urological problem and substitution urethroplasty is the standard treatment for longer (>2 cm) urerthral strictures, multiple urethral strictures and recurrent strictures. Currently, buccal mucosa graft (BMG) is the preferred donor site for substitution urethroplasty which is associated with donor site morbidities. The mucosa covering the lateral and undersurface of the tongue is identical to the rest of the lining of oral cavity and seems to be associated with less risk of donor site complications. The aim of the study was to compare the surgical outcome and donor site morbidity of buccal versus lingual mucosa graft in anterior urethroplasty. Methods: A prospective experimental study was done in the department of Urology Dhaka Medical College Hospital during the period of April 2017 to September 2018. Total 54 Patients were included by purposive sampling for the study as per inclusion and exclusion Criteria. Patients were than allocated into two groups. Group A consisted of 27 patients where Lingual mucosa graft (LMG) urethroplasty done and group B also consisted of 27 patients where Buccal mucosa graft (BMG) urethroplasty done. Results: In the present study, the baseline characteristics of the patients in group A and Group B were almost similar having no statistically significant difference. The overall surgical outcome between two groups was in group A 92% and in group B 88%. The inter-group difference was not statistically significant. Donor site complications more frequently occurred in Group B. Pain in oral cavity at 3rd week in Group A was in 1(4%) patient and in group B was in 9(36%) patients, at 6th month follow up, eating and drinking problem (Group A 4% versus group B 32%), peri-numbness (Group A 4% versus Group B 28%), oral tightness (Group A 0% versus Group B 32%), salivary disturbance (Group A 0% versus Group B 28%) were significant statistically (p<0.05). Conclusion: We conclude that that lingual mucosa ....
Background: The 50% of all male infertility is idiopathic, and there is currently no recognized treatment. The effectiveness of a nonprescription nutraceutical comprising eight nutrients on sperm quality in males with idiopathic infertility was studied. The aim of the study was to evaluate improvement of semen quality after treatment with folic acid and zinc in subfertile men. Methods: This prospective observational study was carried out in the infertility unit, department of obstetrics and gynaecology, Bangabandhu Sheikh Mujib medical university (BSMMU), Dhaka, Bangladesh from January 2018 to June 2020. Approval from local ethics committee was obtained for this study.Results: One hundred and twenty-five male subfertile patients were included in this study. Most men, 99 (79.2%) belong to more than 30 years, followed by 26 (20.8%) less than 30 years, range was 25 to 50 years. Mean ± SD age was 35.3±5.1 years. Rapid linear (RL) before treatment were 16.06±14.46 (mean ± SD) and after treatment were 22.82±13.40 (mean ± SD). Slow linear (SL) before treatment were 17.56±12.06 (mean ± SD) and after treatment were 19.75±9.25 (mean ± SD). Non progressive (NP) before treatment were 10.82±8.95 (mean ± SD) and after treatment were 10.12±7.34 (mean ± SD). Morphology of the sperm before treatment were 19.43±15.48 (mean ± SD) and after treatment were 30.18±19.12 (mean ± SD).Conclusions: Our research findings fully correspond to the above research results, so it can be said that treatment of subfertile men with micronutrients like folic acid and zinc sulfate causes increase of semen quality and thus plays a key role in treatment of male subfertility.
Submission of an original paper with copyright agreement and authorship responsibility.I (corresponding author) certify that I have participated sufficiently in the conception and design of this work and the analysis of the data (wherever applicable), as well as the writing of the manuscript, to take public responsibility for it. I believe the manuscript represents valid work. I have reviewed the final version of the manuscript and approve it for publication. Neither has the manuscript nor one with substantially similar content under my authorship been published nor is being considered for publication elsewhere, except as described in an attachment. Furthermore I attest that I shall produce the data upon which the manuscript is based for examination by the editors or their assignees, if requested.Thanking you.
Background: On patient quality of life, stent-associated symptoms can have a significant impact. Related to indwelling ureteral stents, hematuria, urgency, frequency, dysuria, and both bladder and flank pain are the most prevalent symptoms. Among them low back pain and irritative lower urinary tract symptoms and are more frequent. Because of its importance stent is being kept in situ with varieties of medication despite the stent related symptoms. To relief these symptoms like Tamsulosin, Solifenacin, Alphazosin etc., several alpha-adrenergic blocker and antimuscarinic drugs are used. Tamsulosin and Solifenacin both are not costly as use daily single dose. So combination of Tamsulosin and Solifenacin cost effective and may act as a reliever of stent related symptoms also. Objectives:To evaluate the effect of Tamsulosin and Solifenacin in relieving DJ stent related symptoms. Methodology:This prospective quassi experimental study was performed from November 2016 to April 2018. Patients who placed DJ stent after endoscopic stone management in the Department of Urology, Dhaka Medical College and Hospital recruited as study population. A total of 47 patients who were stented following ureteroscopic lithotripsy were included, allocated purposively into two groups. Group A (Tamsulosin) 24 and and Group B (Solifenacin) 23 patients were selected by purposive sampling technique according to inclusion and exclusion criteria for the study.
A 45 years old male, nondiabetic, hypertensive, nonasthmatic, nonsmoker, farmer from Pabna presented with the complaints of pain over right hypochondrium for 4 months andalso gave history of significant weight loss of about 15 kg in the last 6 months. He also developed bilateral gynecomastia for 2 years.On examination, Blood pressure was 200/100 mm of Hg and bilateral gynecomastia were present.Both testes were mildly atrophied.Systemicexamination revealed mild tenderness in right hypochondrium on deep palpation of abdomen.USG of W/A revealed A heterogenous mixed echogenic mass (9.9*8.9) was seen in upper polar region of right kidney. Suggestive of Right suprarenal mass. CT scan W/A with contrast showed heterogenous contrast enhancing well defined rounded soft tissue density lesion measuring about 90*86 mm was noted in right adrenal region which revealed a right adrenal mass consistent with adrenal pheochromocytoma. However,clinical biochemistry tests revealed normal levels of plasma catecholamines (dopamine,norepinephrine, and epinephrine) and metanephrine, which are unusual findings in adrenal pheochromocytoma.Serum Aldosterone,Basal cortisol, Renin in plasma, ACTH and 24 hours Urinary Free cortisol were normal.Meanwhile, The patient had persistent hypokalemia and serum Testosterone, LH and FSH were below normal level. Open right adrenalectomy was done. Histopathology and immunohistochemistryconfirmed the diagnosis of adrenal pheochromocytoma. Following surgery, the patient did well and showed full recovery at follow-up after one month. To our knowledge, this is the first report in Dhaka Medical college hospital of the extremely rare entity of pheochromocytoma with an unusual clinical and biochemical scenario. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.168-171
Background: The management of VVF involves a multi-modal technique. Surgical repair remains the treatment of choice for VVF. The repair could be undertaken through the transabdominal or transvaginal route. Although the vaginal route was the commonest route employed in the repair of VVF, it is clearly associated with post-operative incontinence, high recurrence and low success rate. Objectives: To compare the outcomes of surgical repair of vesicovaginal fistula between transabdominal and transvaginal Route. Methods: This prospective comparative study intended to compare the outcomes between surgical repair of vesicovaginal fistula- between transabdominal and transvaginal route. A total of 50 cases of VVF patient planned for surgical repair of VVF in Dhaka Medical College Hospital from April 2017 to September 2018, included in this study according to the inclusion and exclusion criteria. Cases were randomly allocated to group A (Transabdominal repair of VVF) and group B (Transvaginal repair of VVF). Each group consisted of 25 patients. The outcome variables were success rate of operation, post-operative complication, post-operative pain, post-operative hospital stay and recurrence. Data were analyzed and compared by statistical tests. Results: No significant differences were found regarding age (p=0.3921), etiology (p=1.000), fistula number (p=0.4174), haematuria (p=0.667), vaginal bleeding (p=1.000), wound infection (p=0.4174) and hospital stay (p=0.4828) between two groups. Post-operative incontinence (p<0.0448) was less in group A than group B cases. Success rate is higher in group A in comparison to group B (p<0.0223). Conclusions: Trans-abdominal route is better than trans-vaginal route in VVF repair. It significantly reduces post-operative incontinence and recurrence of VVF. Success rate is also high in trans-abdominal route than trans-vaginal route. So, VVF repair by trans-abdominal route is safe and effective.
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